Nursing and Midwifery Board of Australia and Paramedicine Board of Australia v Johnstone [2025] VCAT 807 dealt with allegations against Ms Johnstone, who had been a dual registered nurse and paramedic (at the time of the hearing, she was no longer registered as a paramedic).

On 25 September 2021, Ms Johnstone was charged with 21 criminal offences alleging various drug offences between 2 August 2020 and 11 September 2020.  The offending included presenting stolen and forged prescriptions in order to obtain diazepam and selling drugs of dependence in return for cash and methyl amphetamine. She was caught when she attended ‘the home of another registered health practitioner to sell several drugs of dependence’ whilst the home was being observed by Victoria Police ([21[).  She surrendered to police and advised them of the stolen and forged prescriptions ([40])..  After her arrest, but before charges were laid, police reported her to AHPRA ([22]).  When she was charged, she also reported herself to AHPRA ([23]). 

In April 2022, she appeared before the Magistrate’s court where the ‘court found the charges proven and placed Ms Johnstone on a 12 month diversion plan without conviction.’

The offending occurring in 2020. ‘In March 2021 strict conditions were imposed on her employment. In October 2023 those conditions were lifted’ [44]).  After the offending she took part in and completed rehabilitation programs ([49]). The Board did not take ‘immediate action’ ([58]) and she has continued to work ([16]) whilst the matter worked its way through the process. 

In terms of working through the system, Ms Johnstone was referred to the Tribunal by the Nurses and Midwifery Board in February 2023 and by the Paramedicine Board in March 2023.  In May 2023, because the complaints all arose from the same facts, the Tribunal determined to hear the matters together ([6]).  The Tribunal was constituted by a five member panel consisting of a single legal member and 2 nurse practitioner members and 2 paramedic practitioner members ([7]).  There was hearing on 6 February, a decision made on 12 February but the Tribunals reasons were not published until 15 September. Publication of the reasons was ‘long delayed by competing work pressures at VCAT’ ([11]).

The Board accepted that the alleged conduct was proven and constituted professional misconduct with respect to both professions. At [72]-[73] the Tribunal said:

… Ms Johnstone’s conduct in her criminal offending amounts to unprofessional conduct substantially below the standard reasonably expected of a registered nurse or a paramedic of an equivalent level of training or experience to that of Ms Johnstone. Both panels found her conduct was professional misconduct as defined in paragraph (a) of the definition in the National Law.

Ms Johnstone’s conduct, at the time of the offending, was also inconsistent with her being a fit and proper person to hold registration as either a nurse or as a paramedic. The panels found Ms Johnstone’s conduct was professional misconduct as defined in paragraph (c) of the definition in section 5 of the National Law.

The next step was to determine a penalty. It was noted that both the prosecution and defence argued for a non-conviction and a diversion plan when the case was before the Magistrate’s court.  It was noted ‘that it was highly unusual for the prosecution to support a diversion plan where there was a charge of drug trafficking’ ([80]).   At [83]-[88] the Tribunal said:

Ms Johnstone no longer poses a risk to patient safety. Between September and December 2020 she completed two full-time programs of drug rehabilitation. She realised this was necessary for her recovery.

It is relevant that Ms Johnstone was prosecuted by the police because she reported her own drug problem to them. She stated she knows her arrest by the police was a positive intervention in her life.

She was quite open about her problems and her drug addiction with her employer.

The panels were satisfied that the effect of the police proceedings on Ms Johnstone’s life, including recovery and rehabilitation from drug addiction, and the impact it had on her employment, combined with the shame she experienced, and her efforts at rehabilitation, has served a large part of what would ordinarily be necessary for both specific and general deterrence.

Ms Johnstone has the support of her partner, her family, her friends and her employer, to help her deal with the causes of her addiction and the addiction itself, in a way that was not present before her initial inter-action with the police.

She has demonstrated insight into her wrongdoing and remorse for the consequences of that behaviour…

At [89]-[90] they said:

The Tribunal’s role is to protect the public, not to punish the practitioner. That said, our decision must operate to deter Ms Johnstone from repeating her misconduct.

The Tribunal also considers general deterrence. This means warning others in both the nursing and the paramedicine professions against such misconduct in the future. In this instance, the Tribunal is also aware of the need to recognise the good reputation of both professions to which Ms Johnstone belongs, and the fact that her conduct could diminish the reputation of both those professions in the eyes of the public.

And at [98]-[102]:

There is no doubt, despite all the favourable things presented to the Tribunal about Ms Johnstone, that her misconduct deserves a reprimand. Among other things, this is necessary to serve as a public denunciation of her misconduct.

Ms Johnstone’s misconduct was such that it also deserves further sanction, beyond a reprimand. While she did not offend at work, she offended against the criminal law in her private life. But her offending occurred when she was a registered practitioner in both the nursing and the paramedicine professions.

The public is entitled to expect that nurses and paramedics who look after patients will not be involved in criminal behaviour of the type in which Ms Johnstone was involved. Members of the community generally, and members of each of these professions, are entitled to think that members of both professions will not engage in misconduct by criminal behaviour. They are entitled to look to VCAT for condemnation of criminal behaviour in those circumstances, and for consequences for the practitioner that exceed such condemnation.

Ms Johnstone’s behaviour represents a serious lapse in standards that should not be committed by a nurse or a paramedic of her levels of training and experience.

In this instance, the panels were mindful of the need for there to be an emphasis on general deterrence. The Tribunal makes it clear that conduct such as that engaged in by Ms Johnstone would ordinarily incur suspensions and disqualifications for longer than six months. Such conduct jeopardised the health and well-being of patients under her care. However, given Ms Johnstone’s own admission of misconduct, cooperation with Victoria police, achievements in rehabilitation and commitment to her professions, the Tribunal has decided in this instance there will be no cancellation of registration. There will be no period of disqualification, or suspension of registration exceeding six months.

Ms Johnstone’s registration as a nurse was suspended for six months. As she was no longer registered as a paramedic, she was formally reprimanded and an order made disqualifying her from applying for registration for six months.  Those orders came into effect on 12 February 2025 so the six months expired on 12 August 2025, that is about one month before the formal reasons were published.

Discussion

One point that should be discussed, and I’m sure the Boards and Tribunal want discussed, is the message the decision sends. Criminal offending and drug offending in particular are viewed very seriously.  Even offending in private life, noting that Ms Johnstone did not take drugs whilst at work nor did she take drugs from her workplace, still impact upon one’s professional standing.  The case serves as a warning, as it is intended to do, to others – that is what is meant by general deterrence.

Another point is that the whole point of professional registration is to ensure the safety of patients and to ensure that the public can have confidence that those caring for them are fit and proper persons to do so.  The public, and those she nursed, would have had no knowledge of Ms Johnstone’s offending for five years – that is she continued to practice and did so without complaint nor is it alleged any patient was put at harm or risk.

But how can the public have confidence that the system, designed to protect them, is working when it takes 5 years for uncontested matters to be resolved?  There was never any doubt as to the facts.  After the matter had been dealt with in the Magistrate’s court what else did either Board have to do or investigate – yet it took from April 2022 to February and May 2023 for the Board’s to make the relevant complaint to the Tribunal. It took the Tribunal then 2 years to hear the matter – a matter that was not contested.

And Ms Johnstone was suspended for six months 4 and ½ years after the offending during which time she had taken steps to rehabilitate her life and had continued to nurse without incident, even being promoted by her employer. 

I have previously written about the outrageous delays in disciplinary proceedings – see ‘Justice delayed is justice denied’ – QAS paramedic reprimanded nearly 6 years after event (May 21, 2025).  If the police could put the evidence together and the Magistrates court could find the time to hear the criminal matter and resolve the entire case within about 18 months, it is hard – if not impossible – to understand why the Boards and VCAT can not move with more than glacial speed.

As a person outside the system and a potential patient, I find the words of the Tribunals – that their role is to protect the public – of little comfort. Given the delays one can only assume that people are practising who should not be and, as we’ve seen in other cases, practitioners caught up in the system are being subject to conditions or ‘immediate’ suspension for years and in fact much longer than the ultimate penalty. One can only hope that the inquiry by the National Health Practitioner Ombudsman into ‘into delay and procedural safeguards for practitioners who are subject to immediate action’ will do something to shake up the system and getting it working as it is intended.

This blog is a general discussion of legal principles only.  It is not legal advice. Do not rely on the information here to make decisions regarding your legal position or to make decisions that affect your legal rights or responsibilities. For advice on your particular circumstances always consult an admitted legal practitioner in your state or territory.